摘要目的:通过对大鱼际逆行岛状皮瓣重建拇指全指腹后的感觉测定，探讨是否可作为修复拇指指腹缺损的常用术式。方法:自2014年7月至2018年2月，我们采用大鱼际逆行岛状皮瓣重建拇指全指腹缺损患者37例，术后28例获得24个月以上随访，最长随访时间为36个月，平均(25.7±0.5)个月。皮瓣面积最大为4.0 cm×3.0 cm，最小为3.0 cm×2.0 cm。感觉随访内容包括：单丝触觉、两点分辨觉、感觉分级(S 0~S 4)。 结果:单丝触觉中位数：皮瓣远端4.31 mm，皮瓣近端3.61 mm。感觉分级：S 1 6例，S 2 11例，S 3 7例，S 3+ 4例。4例感觉分级S 3+患者的两点分辨觉为20~22 mm，其中2例仅在皮瓣边缘测得，皮瓣中央未测得。 结论:从感觉恢复的角度，大鱼际逆行岛状皮瓣并不是重建拇指全指腹缺损的最佳选择。

abstractsObjective:To investigate whether the thenar reverse island flap can be used as a common method to repair the thumb pulp defects through measuring the sensation of the whole reconstructed thumb pulp.Methods:From July 2014 to February 2018, 37 patients with whole thumb pulp defects were reconstructed by thenar reverse island flap. Among them, 28 patients were follow-up for more than 24 months. The longest follow-up time was 36 months, with an average of (25.7±0.5) months. The maximum flap area was 4.0 cm×3.0 cm, and the minimum flap area was 3.0 cm×2.0 cm. The sensory follow-up included Semmes-Weinstein monofilament, two-point discrimination and sensory grade (S 0 to S 4). Results:The median of Semmes-Weinstein monofilament was 4.31 mm of the flap distal end and 3.61 mm of the flap proximal end. The sensory grade was S 1 in 6 cases, S 2 in 11 cases, S 3 in 7 cases and S 3+ in 4 cases. The two-point discrimination of 4 patients with sensory grade S 3+ was 20 to 22 mm, of which 2 were measured only at the edge of the flap, but not at the center of the flap. Conclusion:From the perspective of sensory recovery, thenar reverse island flap is not the best choice for the reconstruction of the whole thumb pulp defects.